Yoga for multiple sclerosis,
Part I

It started with stress and then a virus. Soon there was numbness on the left side of my belly and back, then a fierce muscular contraction, as though someone was grasping my side and squeezing hard—"the MS hug." The numbness traveled down my left leg, then into the sole of my foot.

That's how MS first showed up for me in 1997.

Considered an autoimmune disease, multiple sclerosis is the most common neurological disease, affecting an estimated 400,000 people in the U.S. Most often diagnosed between the ages of 20 and 50 years old, the disease strikes women three times as often as men. The term "multiple sclerosis" means multiple scars. In MS, the body's immune system attacks the myelin sheath covering the nerve axons of the central nervous system, the brain and spinal cord. Myelin covers the nerve fibers in the same way that plastic covers the bare wire of an electric cord. This covering material insulates and allows the electrical current to move smoothly to its destination. Myelin protects nerve fibers in the same way. When the myelin sheath becomes damaged, nerve signals are interrupted, sending garbled messages into the system.

At the moment there is no medical cure or known cause for MS. Considered partly genetic and partly environmental, MS can be chronic, unpredictable and often disabling, with symptoms ranging from slightly blurred vision to complete paralysis, depending on where the nerve damage occurs. Therefore, MS presents very differently from one person to the next, and from time to time in the same person. There are also gender differences. While fewer men have MS, a higher percentage of men experience faster progression and more challenging symptoms.

Fatigue and balance concerns top the list of common symptoms, followed by muscle weakness and spasticity, numbness and tingling, loss of vision and bladder incontinence. Also common are sleeping problems, depression and cognitive issues related to short-term memory. Not surprisingly, social isolation and loneliness may be fairly common for people who are homebound or lack support and understanding from family and friends. Stress, which can make any health condition worse, is a constant companion for many people who have MS because symptoms are unpredictable and can have devastating effects on relationships, lifestyle and well-being.

The eightfold path of yoga offers a unique and powerful healing path for those with MS. Yoga provides a multifaceted and comprehensive approach to stress relief and symptom management by working simultaneously at the physical, psychological and spiritual levels. Yoga explores the mind-body connection through movement, breath and deep relaxation, helping to coordinate and balance the motor and sensory areas of the brain. Asana and pranayama invite healing on the physical level as well as awareness and insight into the body's sensations, leading to a stillness that draws attention away from what's not working and sets the stage for the deeper healing levels of concentration and meditation. The practice of yoga can transform our perceptions of our circumstances and ourselves.

Because each person's experience of MS is different, some participate in regular classes with little or no need for special consideration. These students may not inform the teacher of their situation. Others may need adaptive classes or individual sessions, which offer traditional yoga postures using props and modifications. For example, some students with MS may not be able to stand or get onto the floor. In these cases, all postures, including Warrior I and II and Triangle, are done in a chair. A second chair can be placed in front of the student for seated versions of Forward Fold, Spinal Twist and Bound Angle.

Students with MS are often overachievers (just as the disease is one of overactivity on the part of the immune system) and may have difficulty relaxing and letting go. The languaging of Kripalu Yoga is particularly suited to this population, i.e., "breathe, relax, feel, watch and allow." I've been teaching students with MS for four years and almost without exception I've found them frustrated by their inability to move their bodies in familiar ways yet resistant to supports such as walkers and chairs that could make their lives easier.

Editor's Note: Part II of Karen's article, coming in the December Yoga Bulletin, will detail teaching considerations, symptom awareness and ways of maintaining safety for students with MS.

Karen Clarke is a certified professional-level Kripalu yoga teacher, Integrative Yoga Therapist and Yoga of the Heart TM instructor. In addition to leading workshops and teaching full-time in southeastern Connecticut, she teaches and consults for the Greater Connecticut Chapter of the National Multiple Sclerosis Society. Karen will offer Adaptive Yoga for Multiple Sclerosis at the 2004 KYTA Conference, Oct. 21-24.